Poisoning Management

Question 1

Paracetemol

Answer 1

activated charcoal if ingested < 1 hour ago
N-acetylcysteine (NAC)
liver transplantation

Question 2

Salicylate

Answer 2

most units now proceeding straight to haemodialysis in cases of severe poisoning haemodialysis

urinary alkalinization is now rarely used - it is contraindicated in cerebral and pulmonary oedema

Question 3

Benzodiazepine

Answer 3

Flumazanil

Question 4

Opioid

Answer 4

Naloxone

Question 5

Tricyclic antidepressants

Answer 5

IV bicarbonate may reduce the risk of seizures and arrhythmias in severe toxicity

Question 6

Lithium

Answer 6

mild-moderate toxicity may respond to volume resuscitation with normal saline

haemodialysis may be needed in severe toxicity

sodium bicarbonate is sometimes used but there is limited evidence to support this. By increasing the alkalinity of the urine it promotes lithium excretion

Question 7

Warfarin

Answer 7

Vit K

Prothrombin complex

Question 8

Heparin

Answer 8

Protamine sulphate

Question 9

Beta blockers

Answer 9

If bradycardic then atropine, in resistant cases glucagon may be used.